07-0604 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&ht 4 4 Q"
BUILDING& SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 07-00.000604
Property Address: 81910 EAGLE CLAW DR.
APN: 764-280-999-27 -300235-
Application description: DWELLING - SINGLE FAMILY DETACHED
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 15.9387
Applicant: rt;hitect or Engineer:
tz"d�rJ
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that Pam'licensed under provisions of Chapter 9 (commencing with
Section 7000 of Division 3 of the Business and Professionals Code,.and my License is in full force and effect.
Li Class:.H License No.: 672285
tract
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1, am'exampt from the Contractor's:State License Lew for the
following reason (Sec: 7031 .5, Business and Professions Code: Any city or, county that requires a permit to
construct, atter; improve, demolish, or repair any structure, prior to its issuance, also requires the, applicant for.the
permit to file a signed statement thathe or sheds licensed pursuant to the provisions.ofthe Contractor's State
License Law (Chapter'9 (commencing with Section=7000) of Division 3 of the Business and Professions Code) or
thathe or she -is exempt therefrom and the basis for thwalleged exemption. Any violation of Section 7031.5 by
any applicant fora permit.subjects the.applicant to a civil penalty of not morethan five hundredidollars (8500).:
(_ 1 I, as owner of the property,,or!myemployees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale(Sec. 7044; Business and Professions Code: The
Contractors ',State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will'. have the burden of proving that he or she did not build or
:improve for the purpose of sale:).
(_ 1 1, as owner of the property, am exclusivelycontracting with licensed contractors to construct the project (Sec.
'7044, Business and Professions Code: The Contractors' State License Law doesrnot.apply to an owner of
property who builds or improves thereon, and who contracts for the projects With a contractors) licensed
pursuant to theContractors' State.License Law.).
(_) I am exempt under Sec. , B.&P:C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
Thereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permitis issued (Sec. 3097, Civ. C.).
Lender's. Name:
Lender's Address:
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CE:
SCOTTSDALE, AZ 8
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:
Contractor:
SHEA HOMES, INC.
8.1260 AVENUE 62
LA QUINTA, .CA 9225'3
(760)777-6005
Lic. No.: 672285
------------------
WORKER'S COMPENSATION DECLARATION
2/26/07
1 hereby affirm under penalty of perjury oneofthe following declarations:
_ 1 have and will maintain a certificate of consent to self4nsure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of, the work for which this permit is
issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier AMERICAN HOME Policy;Number 124:7619
_ I certifythat, in the performance of the work for which this permit Is issued, 1 shall not employ any
person in any manner so as to become subject to the; workers' compensation laws of California,
and agree that, if I sCh Id become subject.to the workers' compensation provisions of Section
. 1 ( 3760 of the Labor 11 fano withmply with ose provisions:
Dai I` t—t �Are�t1 �•• '1#�J l�
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND'SHALL
SUBJECT AN.EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (8100,000). IN ADDITION TO THE COST OF COMPENSATION,. DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE„INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions arid restrictions set forth on this application.
1. Each person upon whose behalf this application: is made, each person at whose request and for
whose.benefn work is performed under or pursuant to any permit.issued as a result of this application,
the. owner, and the.spplicant, each agrees to, and shall defend, indemnify and holt harmless the City
of La.Ouinta, its officers, agents and employees:forany act or omission related to the work being
performed under orfollowing issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
ssu
within 18O days from date of ianoe'of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read thisapplicatiowand state that the above information is correct. '1 agree to comply with all
city and�00 nt ordinances and state laws relating to bu construction, and here orize representatives
of y enter upon above-mentioned pr ( i rp
e:. �� nature (Applicant or Age
Application Number
Permit .. . .
Additional desc . .
Permit Fee . . . .
Issue Date . . .
Expiration Date .
. . . . 07-00000604
BUILDING PERMIT
849.50 Plan Check Fee . . 552.18
Valuation . . . . 1593.87
8/25/07
Qty
Unit Charge
Per
Extension
BASE
FEE
639.50
60.00
3.5000
THOU BLDG
100,001-500,000
210'.00
Permit
. . .
MECHANICAL
Additional
desc .
Permit Fee
65.50
Plan Check Fee
16.38
Issue Date
Valuation . . . .
0
Expiration
Date
8/25/07
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
1.00
9.000.0
EA MECH
FURNACE <=LOOK
9.00
1.00
9.0000
EA MECH
B/C <=3HP/100K BTU
9.00
4.00
6.5060
EA MECH
VENT FAN
26.00
1.00
6.5000
EA MECH
EXHAUST HOOD
6.50
Permit
. . .
ELEC-NEW RESIDENTIAL
Additional
desc . .
Permit Fee
89.84
Plan Check Fee
22.46
Issue Date
Valuation . . . .
0
Expiration
Date
8/25/07
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1773.0.0
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
62.0.6
639.00
-------------------------------------------------------------------------
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
12.78
Permit
. . .
PLUMBING
Additional
desc . .
Permit Fee
. . .
120.00
Plan Check Fe_e
30-.00
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date . .
. 8/25/07
-
Qty Unit Charge
Per
Extension
BASE
FEE
15..00
10.00
6.0000.
EA PLB FIXTURE.
60.00
1.00
15.0000
EA PLB BUILDING SEWER
15.0.0
LQPERMff
Application
Number .
. . .
.
07-00000604
- ------------- -- -- --------------------------------
Special Notes and Comments
Permit
. . . .
PLUMBING
SF.
Qty Unit Charge
Per
MORNING ROOM (24 SF.). PERMIT
Extension
1.00
7.5000
EA
PLB
WATER HEATER/VENT
7.5.0
1.00
3.0000
EA
PLB
WATER INST/ALT/REP
3.00
6.00'
.7500
EA
PLB
GAS PIPE >=5
4.50
1.00
15.0000
EA
PLB
GAS :METER
15.00
Permit GRADING PERMIT
Additional desc .
Permit Fee . . . 15.00
Issue Date . . . .
Expiration Date . . 8/25/07
Plan Check Fee . . .00
Valuation . . . . 0
Qty Unit Charge Per
Extension
BASE FEE
15.00
- ------------- -- -- --------------------------------
Special Notes and Comments
-------------
SFD - LOT 27, PLAN 4515B, 1773
SF.
WITH.4' GARAGE EXT. (10'3SF) &
BOX BAY @
MORNING ROOM (24 SF.). PERMIT
DOES NOT INCLUDE POOL, SPA, BLOCK WALLS
OR DRIVEWAY APPROACH'.
2001 CBC, CMC, CPC, 2.004 CEC,
2005
ENERGY CODES
-----------------.-.--------------------------,--------------------------------
Other Fees . . . . . . .
ART IN PUBLIC PLACES -RES
20.00
DIF COMMUNITY CENTERS -RES
74..00
DIF CIVIC CENTER - RES
995.00
ENERGY REVIEW FEE
55.22
DIF FIRE PROTECTION -RES
140.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
355.60
DIF PARK MAINT FAC - RES
'22.00
DIF PARKS/REC - RES
892..00
STRONG MOTION (SMI), - RES
15.93
DIF STREET MAINT FAC -RES
67.0.0
DIF TRANSPORTATION - RES
1930.00
Fee summary Charged
Paid Credited
Due
Permit Fee Total 1139.84
.0.0 .00
•1139.84
Plan. Check Total 621.02
.00 .00
621.02
Other Fee Total 4566.15
.00 .00
4566.15
Grand Total 6327.0.1
.00 .00
.6327.01